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Early work-related physical exposures and low back pain in midlife: the Cardiovascular Risk in Young Finns Study
  1. T Lallukka1,2,
  2. E Viikari-Juntura1,
  3. J Viikari3,4,
  4. M Kähönen5,6,
  5. T Lehtimäki7,8,
  6. OT Raitakari9,10,
  7. S Solovieva1
  1. 1Finnish Institute of Occupational Health, Helsinki, Finland
  2. 2Department of Public Health, University of Helsinki, Helsinki, Finland
  3. 3Department of Medicine, University of Turku, Turku, Finland
  4. 4Division of Medicine, Turku University Hospital, Turku, Finland
  5. 5Department of Clinical Physiology, University of Tampere, Tampere, Finland
  6. 6Tampere University Hospital, Tampere, Finland
  7. 7Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
  8. 8School of Medicine, University of Tampere, Tampere, Finland
  9. 9Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
  10. 10Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
  1. Correspondence to Dr Tea Lallukka, Finnish Institute of Occupational Health, P.O. Box 40, Helsinki FIN-00251, Finland; tea.lallukka{at}


Objective To examine whether heavy physical workload in young adulthood increases the risk of local and radiating low back pain (LBP) in midlife.

Methods Longitudinal nationally representative Young Finns Study data among women (n=414) and men (n=324), aged 18–24 years in 1986 (baseline), were used. Physical heaviness of work was reported at baseline and follow-up (2007), and local and radiating LBP at follow-up. Covariates were age, smoking and body mass index. Logistic regression was used to examine the associations between physical heaviness of work and LBP. Additionally, the mediating effect of back pain at baseline was examined (the Sobel test).

Results After adjustment for the covariates, and as compared with sedentary/light physical workload, heavy physical workload was associated with radiating LBP among women (OR 4.09, 95% CI 1.62 to 10.31) and men (OR 2.01, 95% CI 1.06 to 3.82). Among men, early back pain mediated the association (p value from the Sobel test=0.006). Among women, early exposure to physically heavy work showed the most consistent associations, while early and late exposures were associated with radiating and local LBP among men. Persistently heavy physical work was associated with radiating LBP among women and men.

Conclusions Physically heavy work at a young age can have a long-lasting effect on the risk of LBP, radiating LBP in particular. These results highlight the need to consider early and persistent exposures to prevent the adverse consequences of physical workload for the low back.

  • radiating low back pain
  • local low back pain
  • physical workload
  • prospective

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